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General NPI Number Information
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NPI Number | 1972820140
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Entity Type | Organization
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Legal Business Name | PEDIATRIC IMPRESSIONS HOME HEALTH INC
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Dates
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Enumeration Date | 04/28/2010
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Last Update Date | 10/04/2012
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Provider Practice Location Address
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Address Line | 8700 COMMERCE PARK DRIVE STE. 146
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City | HOUSTON
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State | TX
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Zip | 77036-7432
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Country | US
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Telephone | 281-954-2554
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Fax | 713-636-3338
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Provider Business Mailing Address
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Address Line | 8700 COMMERCE PARK DR STE 146
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City | HOUSTON
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State | TX
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Zip | 77036-7432
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Country | US
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Telephone | 281-954-2554
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Fax | 713-636-3338
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. IFY CECILIA AGBO
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Credential | BA HONORS/ L.V.N
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Telephone | 281-954-2554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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